The euthansasia debate
1 / 20

The Euthansasia Debate - PowerPoint PPT Presentation

  • Updated On :

The Euthansasia Debate. Dr M Feldman. Medical Ethics. Six of the values that commonly apply to medical ethics discussions are: Beneficence  - a practitioner should act in the best interest of the patient. ( Salus aegroti suprema lex .)

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'The Euthansasia Debate' - mea

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Medical ethics l.jpg
Medical Ethics

Six of the values that commonly apply to medical ethics discussions are:

  • Beneficence - a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)

  • Non-maleficence - "first, do no harm" (primum non nocere)


  • Autonomy - the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)

Medical ethics3 l.jpg
Medical Ethics

  • Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).

  • Dignity - the patient (and the person treating the patient) have the right to dignity.

  • Truthfulness and honesty - the concept of informed consent

Time for a change l.jpg
Time for a change

Public opinion for  - 75 - 80%

Only doctors against

no evidence of slippery slope in Holland

Recent cases

  • Dianne pretty - mnd - wanted to avoid prosecution for husband

        English courts, appeal and European court refused

Time for a change5 l.jpg
Time for a change

  • Debbie Purdy-  MS Again courts have refused to give blanket exemption

  • Daniel James 23 yr old student English  rugby player - no prosectuion

  • Craig Ewert - MND - first televised euthanasia - Dignitas

Time for a change6 l.jpg
Time for a change

Why not here ? 

Patients could wait until needed

The reality of palliative care - personal experince

not for everyone - not for most

Results of questionnaire on dutch model l.jpg

Do you believe in Euthanasia according to Dutch Model

Y = 40%

N = 35%

Dont Know 25%

Would you be prepared to take part

Counsel only 50%

Take part 30%

Would not be involved 20%

Results of Questionnaire on Dutch Model

Results of questionnaire on dutch model8 l.jpg

Has the trip altered your views ?

    More in favour of euthanasia 75%

    Less in favour 5%

    My views are unchanged 20%

Results of Questionnaire on Dutch Model

Tender loving care l.jpg

Tender loving care

Death without intervention

Palliative sedation

< 1-2 weeks before

expected death


Slide10 l.jpg

Type of decision



Stopping or withholding of life-prolonging treatment



Terminal sedation without administation of fluids



Opioids with possible life-shortening effect



Ending of life






assisted suicide



without request



Palliative sedation definitions l.jpg

Palliative sedation - definitions

Definition Health Council: “Bringing a patient in a condition of a deep sleep expecting to maintain it until the death of the patient.”

Royal Dutch Medical Association KNMG: “Deliberately lowering a patient’s consciousness in the last phase of life”

Terminal palliative sedation l.jpg

Terminal / palliative sedation

Refractory symptoms

Life expectancy < 2 weeks

Proportional loss of consciousness

If necessary, until death

No intention to shorten life



Withholding food and fluids?

Alternative for euthanasia?

Source: Royal Dutch Medical Association, Palliative Sedation Guideline; 2002

Euthanasia due care criteria l.jpg

Euthanasia: due care criteria

Well-considered and durable request

Unbearable suffering without prospect of improvement

Proper information to patiënt

No alternatives according to patient and physician

Consultation of independent physician(SCEN)

Medically appropriate realisation

American views l.jpg
American Views

  • Oregon - assisted suicide legal since Oct 97

    • Upheld by supreme court 2006

  • Washington - residents voted 58%to 42% for physician assisted suicide

    • Death within 6 months

    • Can get prescription for lethal drugs

    • Self administer

  • Psychiatric patients excluded

American views15 l.jpg
American Views

  • Rarely used - only 541 Rx with 341 taken 98 - 07

    • Average age 69

    • white middle class

    • Slightly  more men

    • 86% in hospice programmes

Euthanasia objectors l.jpg
Euthanasia objectors

  • Go regularly to church ( whatever religion)

  • Oppose abortion

  • Oppose suicide

  • Oppose capital punishment

  • Worry about power of ' doctors' and dont trust them

Changing opinions l.jpg
Changing opinions

Support for Euthanasia growing

  • Liberal Democrat MP Dr Evan Harris backed Ms Purdy's wish for assisted suicide

  • Scottish MP Margo Macdonald - attempt to  legalise assisted suicide

  • Now 38% of GP want ban lifted 

  •     Similar number would be prepared to be involved

  •     RCGP and BMA - remain opposed